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Obesity now afflicts more than 70 million Americans, and it's a cross-section of the population: rich and poor, young and old, college-educated and high school dropouts.

Today, we have the latest in our series that explores how life is changing in a nation where so many people are dealing with obesity. NPR's Tovia Smith has the story of one woman who despite her smarts and resources, is still struggling in the war with her weight.

TOVIA SMITH: In her 37 years, Kara Curtis has seen every dress size from 26 to 6.

Is that you?

KARA CURTIS: Yup.

(SOUNDBITE OF LAUGHTER)

SMITH: Oh, my gosh.

A lot of old photos show Curtis tall and lean as high school prom queen, and a sprinter for the track and swim teams.

(SOUNDBITE OF LAUGHTER)

CURTIS: Right here.

SMITH: Talk about fit as a fiddle. You're like...

CURTIS: Yeah.

SMITH: ...a rock - solid, I mean...

Growing up in rural upstate New York, Curtis and her family were totally into fitness and nutrition. Imagine a fourth-grade lunchbox with homemade liverwurst on homemade whole-wheat pita and sprouts. It kind of makes sense, Curtis says, that she went crazy for chocolate and cheesy stuff when she was finally living out on her own. But it still took her by surprise after college when she gained nearly 100 pounds in a year.

CURTIS: I remember the first time I heard myself called obese. It was terrible.

SMITH: She was at her doctor's for a regular check-up when he started dictating notes in front of her.

CURTIS: He was like, an obese 22-year-old - you know, like, you know. And I just was like, shocked to hear the word obese related to me.

SMITH: Fifteen years, countless failed diets and another 100 pounds later...

CURTIS: And now I'm morbidly obese. And it's just overwhelming.

SMITH: Being 300 pounds is now the overriding fact of Curtis's life. That's why she put off buying a new car and stuck with an unfulfilling job - because she worried her size would limit her options. It's why she bought a custom-made bathrobe and porch swing, and can't comfortably go to the movies or ride a bike.

Every day is a struggle with the little things, like chafing on her inner thighs or tying her shoes; and with the biggies, like love. With bright eyes and high cheekbones, Curtis is as pretty as she is engaging and witty. And she's totally into kids and family, but totally down on the idea of ever getting back into dating.

CURTIS: It's not like I can fix myself and be done. If you lose the weight, you're still stuck with the stretch marks, the extra skin, the toll that you've taken on your body already. And I'm probably still not going to be excited about getting naked with somebody.

SMITH: It really saps your motivation, Curtis says, when getting fit starts to feel like it's not just difficult, but impossible.

CURTIS: I mean, really, if there was an easy solution, Oprah would have bought it.

(SOUNDBITE OF BLENDER)

SMITH: There is little that Kara Curtis hasn't tried. Her breakfast these days is a pureed concoction of hemp and rice protein, coconut milk and avocado.

CURTIS: Definitely a little lumpier than usual.

SMITH: She has done macrobiotic diets, Weight Watchers, Overeaters Anonymous, 12-step programs, acupuncture, aerobics, meditation, therapy - and yes, exercise.

Unidentified Woman #1: So imagining that your pelvis has a spotlight right on it.

SMITH: Several times a week, Curtis sweats through an intense hour of dance.

Woman #1: Now, play with that quick sway. Right here it's four, three, two, one; four, three...

SMITH: She also begins most days with a vigorous, hour-long walk. But sitting down later to a lunch of a squash soup, Curtis knows what she really needs is not to burn more calories, but to eat less. And yet every time she tries to diet, she ends up bingeing.

CURTIS: This is not a simple thing. Like, there are genetic components. I mean, I look just like my grandmother and my aunts, you know. And so like, you know, clearly, there is this piece that is programmed in.

SMITH: But it's not the only piece, Curtis says. She's as conflicted about what's behind her obesity and how to deal with it as society is. One minute she's all sympathetic and cutting herself slack and one breath later, she's the first to beat herself up.

CURTIS: It's a very schizophrenic relationship with obesity because I understand it as an addiction, but then there's also this other piece of me that knows that there is a lack of willingness on my part. So really, who's to blame for that? Me.

SMITH: On the other-other hand, Curtis adds, it can't be all her fault, when there's so much really crappy food everywhere.

(SOUNDBITE OF BEEPING)

SMITH: Going to the grocery store can be a white-knuckle experience.

CURTIS: Like this right here is, you know - like, almond croissants, you know, biscuits with chocolate on them are always calling out to me. I mean, it would be really hard to walk out of here without something with sugar in it.

SMITH: And when she starts...

CURTIS: I am never going to eat just one cookie. You know, it's three cookies, four cookies, five cookies. And I - you know, there are still times recently that, you know, I've eaten most of a box.

SMITH: What's brutal, Curtis says, is that your failure is out there for everyone to judge.

(SOUNDBITE OF BEEPING)

Unidentified Woman #2: How are you doing today?

CURTIS: Good. How are you?

Woman #2: Fine.

CURTIS: There will be that moment of being like, oh, gosh. I have ice cream on my conveyor belt. Like, there's that pint sitting there. And I catch someone checking me out, like I shouldn't be doing that.

SMITH: It's the same kind of glares she gets on an airplane. These days, Curtis says, it's like her personal problem has become political.

CURTIS: So now it's not just like, well, you're fat and I feel sorry for you. It's you're fat, and that's taking a toll on my life. You know, you're burning more fossil fuels. You're taking, you know - causing more health-care costs. You know, more of a vigilante; it's more harsh.

SMITH: The shame, Curtis says, just ends up making her feel bad and eat more. But she's working hard to get past it. It was a huge step to go on NPR and talk about being fat. Thinking about it, Curtis gets emotional. It's taken a long time, but she's begun to measure progress by more than just her dress size.

CURTIS: I'm really proud of myself for being honest about my situation. And I feel like it's been really gutsy to come out and say like, this is what I struggle with, and I want it to stop.

SMITH: It's all part of a very uneasy paradox, Curtis says. She's got to accept herself and her body, even as she's desperately trying to change it.

CURTIS: There were periods of time when I would hang pictures - skinny pictures of myself up on the refrigerator. And that was just brutal and mean. And I don't want to be brutal and mean to myself.

SMITH: Curtis says she had a huge breakthrough recently when she came out of the shower and caught a reflection of herself in the steamy glass door.

CURTIS: It was the first time that I'd seen that body and not been horrified. And not like I don't want this to change, but it was just about standing there and seeing the entirety of my shape, and still feel loving toward it.

SMITH: Curtis actually took a picture of it. She still looks at it, almost giddy with hope that she might finally be on the way to shedding her excess weight by shedding the shame that surrounds it. On the other hand, she says: I'm also at the highest weight I've ever been, so that might be complete delusion.

Tovia Smith, NPR News.

LOUISE KELLY: This series was produced with help from the Public Insight Network, a project of American Public Media.

(SOUNDBITE OF MUSIC)

LOUISE KELLY: This is NPR News.

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